Abstract

Background: Point-specific needling therapies developed literature, including systematic reviews, randomised independently in several traditional medical systems. Ayurveda's Viddhakarma — a parasurgical, minimally controlled trials, and comparative anatomical studies of marma points and acupoints. invasive puncture technique rooted in the Sushruta Samhita — and Traditional Chinese Medicine (TCM) acupuncture both use needle stimulation of discrete body points to relieve pain and restore function, yet they arose in different civilisations, under different theoretical frameworks, centuries apart. Objective: To systematically compare Viddhakarma and TCM acupuncture across their historical origins, theoretical foundations, technique and instrumentation, clinical indications, proposed mechanisms of action, evidence base, and safety profile. Methods: A narrative comparative review of classical Ayurvedic texts (Sushruta Samhita, Ashtanga Hridaya) Discussion: Both systems share the conceptual architecture of a vital force (Prana/Qi) circulating through a channel network (Nadi–Srotas/Jingluo) and accessible at discrete surface points, and both converge heavily on musculoskeletal pain indications, notably frozen shoulder (Avabahuka) and sciatica (Gridhrasi). They diverge substantially in technique — Viddhakarma is a brief, high- threshold puncture with an intended minor drainage effect, retained for roughly a minute, whereas acupuncture uses sustained needle retention of 15–30 minutes to elicit deqi — and in the depth of their modern clinical evidence base, which is considerably larger and more methodologically mature for acupuncture. Conclusion: Viddhakarma and acupuncture represent two independently evolved but conceptually convergent needling traditions. Their overlap in musculoskeletal indications makes them promising candidates for integrative and translational pain-management research, provided future studies adopt standardised, controlled comparative methodology.